The proposed changes would increase the maximum age band ratio from 3:1 to 3.49:1, place additional restrictions on extended enrollment, and allow payers to end coverage for non-payment after 30 days rather than 90 days.

Dive Insight:

Payers have advocated for these specific changes for some time and they are likely being considered now to encourage participation in ACA exchanges beyond 2017. However, the effort seems inconsistent with attempts by the Trump administration to begin immediately dismantling the 2010 health reform law, as evidenced by a recent executive order instructing federal agencies to relax enforcement of ACA provisions.

The proposed changes, if approved, would likely reduce coverage and make insurance more expensive for elderly people, according to Politico. They could also draw the ire of influential interest groups, such as the AARP, which recently discouraged Congress from passing a proposed bill that would relax age band limits.

If the Trump administration follows through with the proposed changes, the AARP might respond with more than a strongly-worded letter. AARP legislative counsel David Certner told the Hill that the AARP would “consider litigation” if the Trump administration attempts changes that violate the text of the ACA.